Individual provider Active NPI

Daniel Craig Goncher Jr., PA-C

  • Medical Physician Assistant
  • Johnstown, PA
National Provider Identifier
1629074000
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA051699 Issued in PA
Practice address
322 Warren St
Ste 300
Johnstown, PA 15905-3443
Phone
(814) 288-1418
Fax
(814) 288-5427
NPI assigned
Jun 22, 2005
Last updated
Jul 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA051699 PA Primary

Addresses

Primary practice location

322 Warren St
Ste 300
Johnstown, PA 15905-3443

Mailing address

322 Warren St
Ste 300
Johnstown, PA 15905-3443
Phone (814) 288-1418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040729000463 PA Practitioner - Physician Assistant 6305816042 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nulton Diagnostic & Treatment Center, PC. CurrentSince Apr 1, 2017 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Conemaugh Health Initiatives Past Accepting new patients

Locations

214 College Park Plz
Johnstown, PA 15904
Phone (814) 262-0025

Interoperability endpoints

  • Direct secure messaging: pacgoncher@bhmedical.medentdirect.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278028800000",
    "number": "1629074000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 WARREN ST",
            "address_2": "STE 300",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159053443",
            "telephone_number": "814-288-1418",
            "fax_number": "814-288-5427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 WARREN ST",
            "address_2": "STE 300",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159053443",
            "telephone_number": "814-288-1418",
            "fax_number": "814-288-5427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONCHER",
        "first_name": "DANIEL",
        "middle_name": "CRAIG",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2010-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA051699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.